First author Cynthia Herrick, MD, FACP and collaborators had their study published online January 19 in the American Journal of Preventive Medicine. The study focused on the factors associated with the receipt of postpartum diabetes screening for women with gestational diabetes in a state without Medicaid expansion.
Women with gestational diabetes are 7 times more likely to develop type 2 diabetes and require lifelong diabetes screening. Loss of health coverage after pregnancy, as occurs in states that did not expand Medicaid, limits access to guideline-driven follow-up care and fosters health inequity.
In their study, the researchers accessed electronic health record and Medicaid claims data to generate a retrospective cohort of 1,078 women with gestational diabetes. Data analyzed was from women who received their care in 21 FQHC (Federally Qualified Health Centers) systems across Missouri and delivered babies between January 1, 2010 and October 8, 2015.
Age, comorbidity index, receipt of diabetes medication during pregnancy, the number of postpartum visits, having a prenatal visit with a Certified Diabetes Educator, and living in a zip code with access to public transportation remained significantly associated with receipt of recommended screening at the 18-month follow-up.
This study underscores the importance of access to public transportation, prenatal diabetes education, and continued healthcare coverage for women on Medicaid to support the receipt of guideline-recommended follow-up care and improve health equity.